Untitled_3617

State: {Applicant State:2} Date of Application: 02/03/2021 Referred by: Website
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

Ages interested in:
Any age
Gender preferred:
Either a Male or a Female
Color preferred:
Any color
Activity level:
Couch Potato, Quiet, Playful

Other preferences:

Previous dog owner?
Yes
 
Dog 1
 
Dog 1 name:
{Dog Name (Most recent/ current first):24}
 
Dog description:
{Description of Dog:25}
 
How long owned?
{Length of time owned:26}
 
Where is this dog now?
{Where is this dog now? (Explain if you no longer have the dog):37}
  Dog 2
 
Dog 2 name:
{Dog Name (Most recent/ current first):30}
 
Dog description:
{Description of Dog:33}
 
How long owned?
{Length of time owned:35}
 
Where is the dog now?
{Where is this dog now? (Explain if you no longer have the dog):39}
  Dog 3
 
Dog 3 name:
{Dog Name (Most recent/ current first):29}
 
Dog description:
{Description of Dog:32}
 
How long owned?
{Length of time owned:36}
 
Where is dog now?
{Where is this dog now? (Explain if you no longer have the dog):27}
  Dog 4
 
Dog 4 name:
{Dog Name (Most recent/ current first):28}
 
Dog description:
{Description of Dog:31}
 
How long owned?
{Length of time owned:34}
Where is this dog now? {Where is this dog now? (Explain if you no longer have the dog):38}

Who is this dog for?

Myself and my husband…both retired.

Why do you want a Pembroke?
I have never owned a Pembroke welsh corgi but have always thought they were beautiful dogs. I do have a good friend who has a Pembroke and she has been a wonderful pet. I've done some reading on the breed but not a lot of research.

Activities planned with Pembroke:
My husband and I both like to walk. We are snowbirds and travel to FL in the winter so we can walk all year long. Many people in our housing development have dogs so we are always meeting new friends. Its a very dog friendly community.

Aware that Pembrokes are busy, noisy dogs?
Yes

Money for basic care?

Yes

Money for unforeseen medical expenses?
Yes

Willing to house train?
Yes
Willing to do formal training? Yes

Do you have a veterinarian?

Yes

Vet contact info:
{If yes, please provide contact information including the vet’s name, clinic name, street address, city, state, zip, and phone. Also include the website if there is one.:52}

Will handle mistakes Pembroke makes like this:
repetition and redirection

Discipline:
positive reinforcement


Where would Pembroke spend the majority of the time:
Our dogs are part of the family. They would be with us.

Discipline:
positive reinforcement
Where would Pembroke spend the majority of the time: Our dogs are part of the family. They would be with us.

House dog or outside dog?

House dog

People at home during the day?
Yes, we are both retired so usually one of us is home during the day.

Where would dog eat?
In the kitchen where we eat.

Where would dog sleep:
probably in a crate if they are crate trained. if not, they would have a bed probably somewhere in our bedroom

Play & exercise:
like I stated earlier, we both like to walk so that would be the main form of exercise for all of us. we have our own homes in FL and IN so there would be room for ball fetching, etc inside.

How will you exercise your dog?
On leash

Fenced yard?

No, I don’t have a fenced in yard.

Willing to pick up dog waste?
Yes, I will clean up after my dog.

Willing to use a crate?

Living arrangements:
Own home

Landlord info:
{If you rent/lease your home, please list the name, telephone number and email address of your landlord. State “Not Applicable” if you own your own home.:67}

May we contact your landlord?

Lease allow dogs:

Landlord permission:

Restrictive covenants?
Not applicable

Breed/size restrictions?
No

Description of yard:

We have three acres but it is not fenced in…we have a creek and a pond in the back.

Household members:
{Describe all the people who live in your home, include names, ages and interests. For example, Mary Smith, 29, Enjoys cooking, dog training, gardening and running.:75}

Everyone in household agrees about adopting a corgi?
Yes, everyone agrees and wants to adopt a Pembroke Welsh Corgi.

May we do a home visit?

Yes, I will allow LPWCR representatives to inspect my home prior to allowing me to adopt a Pembroke.

Who will be responsible for the adopted corgi’s care?
Wilma

Willing to train children?
yes…I have two grandchildren, ages 9 and 11. They have a dog, three cats, and three chickens. They both love their pets and take very good care of them.

Any allergies?

No one is allergic.

Current pets:

{Please list and describe all of the pets that currently live in your home, including the name, type, age, sex and whether it is neutered. For example, Lenny, komodo dragon, 3 years old, not neutered.:80}

Current pets dog friendly?


Are you willing to work on it if your new dog doesn’t get along with your current pets right away?
no other pets and not planning on any more than one dog

Lifetime commitment to Pembroke?

Yes, I am willing to commit to this dog for the rest of its life.

Return to Lakeshore if unable to care for Pembroke?
Yes, I will only surrender my adopted corgi to LPWCR if I am unable to care for it.

Understand no guarantees?

Yes, I understand that there are no guarantees regarding the condition, health, behavior or personality of the Pembroke I adopt.

Carefully considered the pluses and minuses of adopting a pet?
Yes, I have carefully thought out my decision to adopt a Pembroke and am willing to deal with the consequences.

Personal references:
{Personal References. Please list two people who know your family well, but who are not related to you (No moms, grandmas, sisters, etc) who will attest to the fact that you are a responsible, dedicated pet owner. Include the name of the person, their phone number(s), email and relationship you have with that person. For example, Mary Smith, 123-343-4444, 123-333-5767, marys@gmail.com, friend.:87}